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Hyperthyroidism (overactive thyroid) : Symptoms, Causes, Diagnosis and Treatment

What is Hyperthyroidism?

Hyperthyroidism (overactive thyroid) occurs when your thyroid gland produces too much of the hormone thyroxine. Hyperthyroidism can accelerate your body's metabolism, causing unintentional weight loss and a rapid or irregular heartbeat.

Several treatments are available for hyperthyroidism. Doctors use anti-thyroid medications and radioactive iodine to slow the production of thyroid hormones. Sometimes, hyperthyroidism treatment involves surgery to remove all or part of your thyroid gland.

Although hyperthyroidism can be serious if you ignore it, most people respond well once hyperthyroidism is diagnosed and treated.

Hyperthyroidism is also known as overactive thyroid. Hyperthyroidism belongs under the category of Thyroid disease. Generally Male,Female are the victim of the Hyperthyroidism. Seriousness of this disease is Medium.

Symptoms of Hyperthyroidism are :

  • Shaking in your hands and fingers (tremor)
  • More bowel movements
  • a swollen in thyroid
  • Sensitivity to heat
  • thinning of the skin
  • irregular heart beat
  • Irregular menstrual cycle or Irregular periods
  • On average, The normal length of a woman?s menstrual cycle is 24 to 38 days. A period usually lasts about 2 to 8 days. So this varies between individuals. When the length of the cycle is more than 35 days, or if the duration varies then it is called irregular menstruation or irregular periods.

  • mood swings
  • brittle hair and nails
  • Sleep problems
  • Anxiety
  • A faster heartbeat
  • A rapid or fast heartbeat is when your heart is beating faster than normal. A normal heart rate is 60 to 100 beats per minute. Tachycardia is considered a heart rate of greater than 100 beats per minute.
    If you are exercising, or performing any kind of activity, your heart will normally beat faster. This allows your heart to pump blood throughout your body, to provide oxygen to the tissues.
    If you are experiencing fear, anxiety or stress, your heart rate will increase.

    People who can feel their heartbeat, or flutter, may be experiencing palpitations. This may be due to stress, anxiety, medications, or it may be a sign of a serious heart condition. If you experience palpitations, you should report this to your healthcare provider.

  • Weight loss
  • Sudden, noticeable weight loss can happen after a stressful event, although it can also be a sign of a serious illness.

    It's normal to lose a noticeable amount of weight after the stress of changing jobs, divorce, redundancy or bereavement.

    Weight often returns to normal when you start to feel happier, after you've had time to grieve or get used to the change. Counselling and support may be needed to help you get to this stage.

    Significant weight loss can also be the result of an eating disorder, such as anorexia or bulimia. If you think you have an eating disorder, talk to someone you trust and consider speaking to your GP. There are also several organisations that can provide you with information and advice, such as the eating disorders charity Beat.

    If your weight loss wasn't due to one of the causes mentioned, and you didn't lose weight through dieting or exercising, see your GP, as you may have an illness that needs treating.

  • Fatigue/weakness
  • Weakness

    Weakness is when strength is decreased and extra effort is needed to move a certain part of the body or the entire body. Weakness is due to loss of muscle strength. Weakness can be a big part of why cancer patients feel fatigue.

    Fatigue

    Fatigue is an extreme feeling of tiredness or lack of energy, often described as being exhausted. Fatigue is something that lasts even when a person seems to be getting enough sleep. It can have many causes, including working too much, having disturbed sleep, stress and worry, not having enough physical activity, and going through an illness and its treatment.

    Causes

    Hyperthyroidism can be caused due to:

    Hyperthyroidism can be caused by a number of conditions, including Graves' disease, Plummer's disease and thyroiditis.

    Your thyroid is a small, butterfly-shaped gland at the base of your neck, just below your Adam's apple. The thyroid gland has an enormous impact on your health. Every aspect of your metabolism is regulated by thyroid hormones.

    Your thyroid gland produces two main hormones, thyroxine (T4) and triiodothyronine (T3), that influence every cell in your body. They maintain the rate at which your body uses fats and carbohydrates, help control your body temperature, influence your heart rate, and help regulate the production of protein. Your thyroid also produces a hormone that helps regulate the amount of calcium in your blood (calcitonin).

    Reasons for too much thyroxine (T4)

    Normally, your thyroid releases the right amount of hormones, but sometimes it produces too much T4. This may occur for a number of reasons, including:

    • Graves' disease. Graves' disease is an autoimmune disorder in which antibodies produced by your immune system stimulate your thyroid to produce too much T4. It's the most common cause of hyperthyroidism.

    • Hyperfunctioning thyroid nodules (toxic adenoma, toxic multinodular goiter or Plummer's disease). This form of hyperthyroidism occurs when one or more adenomas of your thyroid produce too much T4. An adenoma is a part of the gland that has walled itself off from the rest of the gland, forming noncancerous (benign) lumps that may cause an enlargement of the thyroid.

    • Thyroiditis. Sometimes your thyroid gland can become inflamed after pregnancy, due to an autoimmune condition or for unknown reasons. The inflammation can cause excess thyroid hormone stored in the gland to leak into your bloodstream. Some types of thyroiditis may cause pain, while others are painless. Other causes of hyperthyroidism include:

    • excess iodine, a key ingredient in T4 and T3

    • thyroiditis, or inflammation of the thyroid, which causes T4 and T3 to leak out of the gland

    • tumors of the ovaries or testes

    • benign tumors of the thyroid or pituitary gland

    • large amounts of tetraiodothyronine taken through dietary supplements or medication

    What kind of precaution should be taken in Hyperthyroidism?

    You cannot prevent hyperthyroidism. However, some people are more at risk for the condition. This includes people who:

    Were born female. Have a family history of thyroid disease. Are younger than 40 or older than 60. Have certain problems, such as type 1 diabetes, pernicious anemia, or an immune system disorder. Consume large amounts of iodine, either through food or medicine

    Treatment for the Hyperthyroidism

    Diagnosis:

    Hyperthyroidism is diagnosed using:

    • Medical history and physical exam. During the exam your doctor may try to detect a slight tremor in your fingers when they're extended, overactive reflexes, eye changes and warm, moist skin. Your doctor will also examine your thyroid gland as you swallow to see if it's enlarged, bumpy or tender and check your pulse to see if it's rapid or irregular.

    • Blood tests. Blood tests that measure thyroxine and thyroid-stimulating hormone (TSH) can confirm the diagnosis. High levels of thyroxine and low or nonexistent amounts of TSH indicate an overactive thyroid. The amount of TSH is important because it's the hormone that signals your thyroid gland to produce more thyroxine.

      These tests are particularly necessary for older adults, who may not have classic symptoms of hyperthyroidism.

      Thyroid blood tests may give false results if you're taking biotin ? a B vitamin supplement that may also be found in multivitamins. Let your doctor know if you are using biotin or a multivitamin with biotin. To ensure an accurate test, stop taking biotin at least 12 hours before blood is taken.

    If blood tests indicate hyperthyroidism, your doctor may recommend one of the following tests to help determine why your thyroid is overactive:

    • Radioiodine uptake test. For this test, you take a small, oral dose of radioactive iodine (radioiodine) to see how much will collect in your thyroid gland. You'll be checked after four, six or 24 hours ? and sometimes after all three time periods ? to see how much iodine your thyroid has absorbed.

      A high uptake of radioiodine indicates your thyroid gland is producing too much thyroxine. The most likely cause is either Graves' disease or hyperfunctioning thyroid nodules. If you have hyperthyroidism and your radioiodine uptake is low, this indicates that the thyroxine stored in the gland is leaking into the bloodstream, which may mean you have thyroiditis.

    • Thyroid scan. During this test, you'll have a radioactive isotope injected into the vein on the inside of your elbow or sometimes into a vein in your hand. You then lie on a table with your head stretched backward while a special camera produces an image of your thyroid gland on a computer screen. This test shows how iodine collects in your thyroid.

    • Thyroid ultrasound. This test uses high-frequency sound waves to produce images of the thyroid. Ultrasound may be better at detecting thyroid nodules than other tests, and there's no exposure to any radiation.

    Other test for Hyperthyroidism disease:

    • Thyroid Function Tests
    • Thyroid Scan and Uptake
    • Thyroid Tests
    • Thyroxine (T4) Test
    • Triiodothyronine (T3) Tests
    • TSH (Thyroid-stimulating hormone) test

    Treatment:

    Several treatments for hyperthyroidism exist. The best approach for you depends on your age, physical condition, the underlying cause of the hyperthyroidism, personal preference and the severity of your disorder. Possible treatments include:

    • Radioactive iodine. Taken by mouth, radioactive iodine is absorbed by your thyroid gland, where it causes the gland to shrink. Symptoms usually subside within several months. Excess radioactive iodine disappears from the body in weeks to months.

      This treatment may cause thyroid activity to slow enough to be considered underactive (hypothyroidism), and you may eventually need to take medication every day to replace thyroxine.

    • Anti-thyroid medications. These medications gradually reduce symptoms of hyperthyroidism by preventing your thyroid gland from producing excess amounts of hormones. They include methimazole (Tapazole) and propylithiouracil. Symptoms usually begin to improve within several weeks to months, but treatment with anti-thyroid medications typically continues at least a year and often longer.

      For some people, this clears up the problem permanently, but other people may experience a relapse. Both drugs can cause serious liver damage, sometimes leading to death. Because propylthiouracil has caused far more cases of liver damage, it generally should be used only when you can't tolerate methimazole.

      A small number of people who are allergic to these drugs may develop skin rashes, hives, fever or joint pain. They also can make you more susceptible to infection.

    • Beta blockers. Although these drugs are usually used to treat high blood pressure and don't affect thyroid levels, they can ease symptoms of hyperthyroidism, such as a tremor, rapid heart rate and palpitations. For that reason, your doctor may prescribe them to help you feel better until your thyroid levels are closer to normal. These medications generally aren't recommended for people who have asthma, and side effects may include fatigue and sexual dysfunction.

    • Surgery (thyroidectomy). If you're pregnant or you otherwise can't tolerate anti-thyroid drugs and don't want to or can't have radioactive iodine therapy, you may be a candidate for thyroid surgery, although this is an option in only a few cases.

      In a thyroidectomy, your doctor removes most of your thyroid gland. Risks of this surgery include damage to your vocal cords and parathyroid glands ? four tiny glands situated on the back of your thyroid gland that help control the level of calcium in your blood.

      In addition, you'll need lifelong treatment with levothyroxine (Levoxyl, Synthroid, others) to supply your body with normal amounts of thyroid hormone. If your parathyroid glands also are removed, you'll need medication to keep your blood-calcium levels normal.

    Graves' ophthalmopathy

    If Graves' disease affects your eyes (Graves' ophthalmopathy), you can manage mild signs and symptoms by using artificial tears and lubricating gels and by avoiding wind and bright lights. If your symptoms are more severe, your doctor may recommend treatment with corticosteroids, such as prednisone, to reduce swelling behind your eyeballs.

    Two drugs ? rituximab (Rituxan) and teprotumumab ? are being used to treat Graves' ophthalmopathy, even though there isn't a lot of definitive evidence yet to prove that they're effective. Teprotumumab received fast-track approval from the Food and Drug Administration based on one small study. More study of both drugs as a treatment for Graves' ophthalmopathy is needed.

    In some cases, a surgical procedure may be an option:

    • Orbital decompression surgery. In this surgery, your doctor removes the bone between your eye socket and your sinuses ? the air spaces next to the eye socket. When the procedure is successful, it improves vision and provides room for your eyes to return to their normal position. But there is a risk of complications, including double vision that persists or appears after surgery.
    • Eye muscle surgery. Sometimes scar tissue from Graves' ophthalmopathy can cause one or more eye muscles to be too short. This pulls your eyes out of alignment, leading to double vision. Eye muscle surgery may help correct double vision by cutting the affected muscle from the eyeball and reattaching it farther back.

    Possible complication with Hyperthyroidism

    Hyperthyroidism can lead to a number of complications:

    • Heart problems. Some of the most serious complications of hyperthyroidism involve the heart. These include a rapid heart rate, a heart rhythm disorder called atrial fibrillation that increases your risk of stroke, and congestive heart failure ? a condition in which your heart can't circulate enough blood to meet your body's needs.
    • Brittle bones. Untreated hyperthyroidism can also lead to weak, brittle bones (osteoporosis). The strength of your bones depends, in part, on the amount of calcium and other minerals they contain. Too much thyroid hormone interferes with your body's ability to incorporate calcium into your bones.
    • Eye problems. People with Graves' ophthalmopathy develop eye problems, including bulging, red or swollen eyes, sensitivity to light, and blurring or double vision. Untreated, severe eye problems can lead to vision loss.
    • Red, swollen skin. In rare cases, people with Graves' disease develop Graves' dermopathy. This affects the skin, causing redness and swelling, often on the shins and feet.
    • Thyrotoxic crisis. Hyperthyroidism also places you at risk of thyrotoxic crisis ? a sudden intensification of your symptoms, leading to a fever, a rapid pulse and even delirium. If this occurs, seek immediate medical care.

    References:

    1 https://www.mayoclinic.org/diseases-conditions/hyperthyroidism/symptoms-causes/syc-20373659 2 https://www.healthline.com/health/hyperthyroidism#symptoms 3 https://medlineplus.gov/hyperthyroidism.html#cat_92 4 https://www.medicinenet.com/hyperthyroidism/article.htm 5 https://www.webmd.com/a-to-z-guides/overactive-thyroid-hyperthyroidism#1 6 https://www.niddk.nih.gov/health-information/endocrine-diseases/hyperthyroidism 7 https://www.endocrineweb.com/conditions/hyperthyroidism/hyperthyroidism-overview-overactive-thyroid 8 https://familydoctor.org/condition/hyperthyroidism/

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